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目的:探讨经腹膜外途径腹腔镜下前列腺癌根治术(ELRP)的手术方法和临床效果。方法:对2011年6月~2014年2月行ELRP术29例患者的临床资料进行回顾性分析:患者年龄60~77岁,平均68岁。所有患者均于术前行前列腺穿刺活组织检查或前列腺电切术后经病理检查证实为前列腺癌,术前总PSA平均18.9μg/L,其中<4.0μg/L者2例,4~20μg/L者16例,>20μg/L者11例。均行ELRP。结果:手术时间60~330min,平均125min;术中出血量80~1 200ml,平均150ml;术中输血2例。1例因阴茎背静脉复合体出血中转开放手术。术中直肠损伤1例。术后病理检查均证实为前列腺癌,Gleason评分6~9分,切缘阳性3例。术后留置导尿管时间12~26d,平均15d。拔除尿管后出现轻度尿失禁8例,术后1~3个月均可满意控尿。术后3个月检查血清PSA为0~0.18μg/L,未发现肿瘤局部生化复发和远处转移。结论:ELRP创伤小,并发症少,患者恢复快,是治疗局限性前列腺癌安全有效的手术方法。
Objective: To investigate the surgical method and clinical effect of laparoscopic radical prostatectomy (ELRP) by extraperitoneal route. Methods: The clinical data of 29 patients undergoing ELRP from June 2011 to February 2014 were retrospectively analyzed. The patients were aged from 60 to 77 years with an average of 68 years. All patients underwent preoperative prostate biopsy or prostatectomy confirmed by pathological examination of prostate cancer, preoperative total PSA was 18.9μg / L, of which <4.0μg / L in 2 cases, 4 ~ 20μg / L in 16 cases,> 20μg / L in 11 cases. All ELRP. Results: The operation time was 60 ~ 330min with an average of 125min. The intraoperative blood loss was 80 ~ 1 200ml with an average of 150ml. There were 2 cases of intraoperative blood transfusion. 1 case of penile dorsal venous venous bleeding due to open conversion surgery. One case of intraoperative rectal injury. Postoperative pathological examination were confirmed as prostate cancer, Gleason score 6 to 9, the positive edge of 3 cases. Postoperative indwelling catheter time 12 ~ 26d, an average of 15d. Urine incision occurred in 8 cases of mild incontinence, 1 to 3 months after surgery can be satisfied with the control of urine. Serum PSA was 0 ~ 0.18μg / L at 3 months after operation, and no local tumor biochemical recurrence or distant metastasis was found. Conclusion: ELRP is a safe and effective surgical method for the treatment of localized prostate cancer with less trauma, fewer complications and faster recovery.